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4. European Vascular Nurses & Sonographers Overview

European Vascular Nurses and Sonographers (EVNS)

Me

I am a practising Clinical Vascular Scientist (AVS)  in London Imperial College NHS Trust. I fully embrace the responsibility and role we play in patient pathway alongside nurses and surgeons. This is the only vascular lab I have ever worked at since being introduced to the probe in 2014. For the first 4 years I didn’t know any better or worse way of practice. Now I have been part of the EVNS  steering committee for 2 years and I have learnt a lot.

 

History of EVNS

Since 2009 almost every year there have been dedicated sessions for vascular nurses at the ESVS Annual Meeting. The program used to be arranged by local committees in the hosting country.

Following round-table discussions that took place during the Nurses’ Session at the ESVS Annual Meeting in Copenhagen in 2016, a formal proposal letter was sent to the ESVS Committee. The aim was to create a vascular society inclusive of healthcare professionals looking after patients with vascular disease. ESVS fully supported the venture and steering committee for the European Vascular Nurses and Sonographers was formed. The objective of the committee was to create a  forum for allied healthcare professionals working in vascular centres across Europe.

Currently the committee consists of four nurses and  four sonographers. There are regular meetings with the ESVS Executive Committee to voice interests, raise issues and discuss future directions.

 

Brief picture of vascular sonography in Europe 

As described in previous Newsletter article about ultrasound scanning in Belgium, the profession of Clinical Vascular Scientist does not exist in many European countries. Scans are often performed by medical doctors, nurses and/or other healthcare professionals, for example vascular assistants in Germany. Performing ultrasound is often an add-on to their main duties and, therefore gets inevitably less time for practise, especially when compared to vascular labs in the UK that are fully dedicated to vascular scanning only. Lack of standardised training and regulations in Europe has led to  great disparity of skill and knowledge available for ultrasound practitioners, many of which struggle to access resources needed for specialist training. As a result, it is no surprise that current situation does not only compromise quality and safety of ultrasound scanning, but also leads to under-utilisation of non-invasive imaging and over-utilisation of invasive imaging, such as CT scans.

 

Role of EVNS for vascular sonography 

EVNS has set out to connect ultrasound practitioners with various backgrounds providing them dedicated time and space during ESVS Annual meetings. Every year the conference takes place in a different European city opening an opportunity to local allied healthcare professionals who otherwise would find it difficult to attend such meetings. From the other side, travelling to a new locations, to either present a piece of work or simply listen, gives invaluable insights to learn about the complicated picture of vascular ultrasound practises across Europe. Although sometimes strange, sometimes shocking, I strongly believe that such diverse scene provides a fertile ground for everyone to learn from each other. It is important to embrace such mix of experiences from local and visitors’ side, only then we can work together on setting directions for better future.

For example, we bring healthcare professionals from different countries to a round table for a multi-disciplinary style team meeting to discuss a vascular case study. Every speaker shares insights of their role in their home center and share their professional perspective of a case study. That gives a chance to learn about different team set-ups and efficiencies in patient pathways from our European neighbours. Some of the speakers represent a profession that is non-existent in some countries. Prime example is clinical vascular scientists, but also podiatrists, vascular assistants and endovascular assistants (EVAs) are inherent parts of vascular teams in some, but complete aliens to others.

In addition to scientific program delivering sessions about interesting cases, scientific abstracts, innovation and quality of care, there are also various practical workshops for nursing care and basic ultrasound scanning. 

For the last 2 years there has also been an opportunity for ultrasound practitioners to sit an exam to obtain a Certificate of Minimal Competence. There are two requirements for application: 1) recognised profession in healthcare setting and 2) log book of totalling >100 supervised vascular ultrasound scans with equal contribution of carotids, lower limb venous, arterial and abdominal aorta scans. On the day, candidates are expected to sit a written theory exam and practical test performing 2-3 scans on normal subjects. Successful completion of all the tests will get awarded with the Certification of Minimal Competence. It is by no means licence to practise or any form of accreditation. However, it serves as recognition for ultrasound practitioners who have been scanning for years but have received no acknowledgement for their skills. 

 

Future

EVNS has been active for three years and slowly establishing its members’ base. The challenges ahead are eminent, albeit offer great rewards. It is important to recognise that some differences are historic and multi-dimensional. These will take long to shift, if ever. Appreciating disparity, EVNS aims to offer resources and support to build  professionalisms and competence for everyone who is open to learn. 

In addition to current activities, the society has potential to connect research interests and form scientific collaboration projects across Europe. Such initiatives are destined to thrive with global impact and shape the future of vascular services. 

To encourage initiatives ESVS offers generous grants to cover registration, travel and education costs. 

Come and join us in Poland, Kracow 2020, September 29th - October 2nd. (edit - TBC)

Mari Murumets

Charing Cross Hospital, Imperial College, London